国产单环网篮导丝在冠状动脉慢性完全闭塞病变逆向介入治疗中的应用  

Application of domestic snare in retrograde percutaneous coronary intervention for coronary chronic total occlusion lesions

作　　者：赵林[1] 金泽宁[1] 张晓江[1] 何东方[1] 罗亚玮[1] 宋现涛[1] 柳景华[1] 郭成军[1] 李贵华[2] 王雷[3] 王冰[4] 陈少青[5] 孙洪涛[5] 吕德[6] 

机构地区：[1]首都医科大学附属北京安贞医院心内科,北京100029 [2]北京市垂杨柳医院心内科 [3]首都医科大学附属北京友谊医院心内科 [4]泰山医学院附属邹平县人民医院心内科,山东滨州 [5]内蒙古民族大学医学院附属医院心内科,内蒙古通辽 [6]山东中医药大学附属临沂市中医院心内科,山东临沂

出　　处：《中国介入心脏病学杂志》2017年第4期197-201,共5页Chinese Journal of Interventional Cardiology

摘　　要：目的评价国产单环网篮导丝在冠状动脉慢性完全闭塞病变(chronic total occlusion,CTO)逆向介入治疗中的有效性和安全性。方法连续入选2012年3月至2016年11月冠状动脉CTO病变逆向介入治疗中应用国产单环网篮导丝27例患者。分析患者的临床基本资料、CTO特点、网篮导丝使用情况、术中并发症发生情况及住院期间主要不良心血管事件(MACE,包括心源性死亡、再发急性心肌梗死和靶血管再次血运重建)发生情况。结果 27例患者术中均使用国产单环网篮导丝协助逆向导丝体外化,平均用时(3.5±5.4)min,其中单环网篮导丝协助微导管通过病变6例。26例患者成功置入支架,1例患者因冠状动脉严重钙化未能成功置入支架。术中未发生单环网篮导丝引起的夹层破裂、导丝断裂、圈套器不能松解、血管穿孔等严重并发症。住院期间无MACE发生。结论逆向介入治疗CTO过程中应用国产单环网篮导丝协助逆向导丝进入正向指引导管,完成逆向导丝体外化是安全、有效的,可以简化介入治疗操作步骤。Objective To evaluate the safety and efficiency of domestic snare applied during retrograde percutaneous coronary intervention（ PCI） for chronic total occlusion（ CTO） lesions.Methods A total of 27 patients who underwent retrograde PCI for CTO and used domestic snare during the procedure were enrolled in our study from March 2012 to November 2016. Clinical data,angiographic characteristics and PCI details were collected. Clinical data,characteristics of CTO lesion,effect of the domestic snare and snaring time were retrospectively analyzed. Special complications related to the domestic snare and major adverse cardiovascular events（ MACE） were also documented. Results Domestic snare was used in all the procedures,which included facillitating the micro-catheter to pass through the CTO lesions in 6 patients and assisting the RG3/rotational guide-wire externalization in all the 27 patients. Mean snaring time was 3. 5 ± 5. 4 minutes. Stents were successfully implanted in 26 patients except in 1 patient who failed to receive stent implantation for severe coronary calcification. No complications including coronary dissection,fracture of guide-wire and unreleased snare happened during the procedures and no MACE occurred during hospitalization. Conclusions Domestic snare facilitates retrograde micro-catheter crossing CTO lesions and retrograde guide-wire entering the guiding catheter and externalization. It is a simple,safe and efficient method.

关 键 词：慢性完全闭塞病变 国产单环网篮导丝 逆向介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]